Table 4.

Deterministic outcomes of the cost-utility analysis on navigated surgery compared to standard surgery: base case and scenarios

A. Base case results
	Treatment costs	QALYs	LYs	iCosts	iQALYs	ICER	Conclusion
Base case results LARC
Navigated surgery	€26.379	2.05	2.53				Navigated surgery is more effective, more costly. Costs are above the WTP of €80.000/QALY
Standard surgery	€23.238	2.02	2.50
				€3.141	0.02	€136.604
Base case results LRRC
Navigated surgery	€28.060	1.73	2.17				Navigated surgery is more effective, more costly. Costs are below the WTP of €80.000/QALY
Standard surgery	€25.164	1.67	2.11
				€2.896	0.06	€52.510
B. Results from the scenario analysis
			Intervention		ICER scenario	Conclusion scenario
Scenario 1: A hybrid OR has to be constructed before the navigation system can be used			LARC		€266.019	Navigated surgery is more effective, more costly. Costs are above the WTP of €80.000/QALY
			LRRC		€106.458	Navigated surgery is more effective, more costly. Costs are above the WTP of €80.000/QALY
Scenario 2: Increase in utilization of the navigation system to 50%			LARC		€61.817	Navigation is more effective, more costly. Costs are below the WTP of €80.000/QALY
			LRRC		€21.334	Navigation is more effective, more costly. Costs are below the WTP of €80.000/QALY
Combination of 1 and 2: increased use of the navigation system and including the costs of constructing a hybrid OR to use the navigation system#			LARC		€ 191.232	Navigated surgery is more effective, more costly. Costs are above the WTP of €80.000/QALY
			LRRC		€ 75.282	Navigation is more effective, more costly. Costs are below the WTP of €80.000/QALY

The WTP threshold used was €80.000. QALYs Quality of life years, Lys Life years, iCosts incremental costs, iQALYs incremental Quality of life years, ICER Incremental cost-effectiveness ratio, WTP Willingness To Pay threshold. # = total costs for the use of navigation including the hybrid OR costs assuming a use of 50% = €4.644,28